Jaisy Jacob, - Medicare Diagnostic Radiology in Detroit, MI

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Jaisy Jacob, is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Detroit, Michigan. She graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Diagnostic Radiology. She is a member of the group practice Henry Ford Medical Group and her current practice location is 4100 John R St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 576-9900.

Jaisy Jacob is licensed to practice in Michigan (license number 4301107800) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639468614.

Contact Information

Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013
(313) 576-9900
Not Available

Map and Direction




Physician's Profile

Full NameJaisy Jacob
GenderFemale
SpecialityDiagnostic Radiology
Experience13 Years
Location4100 John R St, Detroit, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jaisy Jacob graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1639468614
  • Provider Enumeration Date: 03/30/2011
  • Last Update Date: 05/13/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2466765276
  • Enrollment ID: I20180822001806

Medical Identifiers

Medical identifiers for Jaisy Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639468614NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085B0100XRadiology - Body Imaging 4301107800 (Michigan)Secondary
2085R0202XRadiology - Diagnostic Radiology 4301107800 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Henry Ford Macomb HospitalClinton township, MIHospital
Henry Ford West Bloomfield HospitalWest bloomfield, MIHospital
Henry Ford HospitalDetroit, MIHospital
Henry Ford Wyandotte HospitalWyandotte, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Henry Ford Medical Group05471783112124

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jaisy Jacob allows following entities to bill medicare on her behalf.
Entity NameHenry Ford Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134144801
PECOS PAC ID: 0547178311
Enrollment ID: O20031105000139

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaisy Jacob is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013

Ph: (313) 576-9900		Jaisy Jacob,
4100 John R St,
Detroit, MI 48201-2013

Ph: (313) 576-9900

Reviews and Comments


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Kristan Gail Jenkins-mosure, M.D.
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Kristin Booth, DO
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.